Dad told me he doesn't want to be taken to hospital if he's unconscious, under any circumstances

[falstaff1980]

He had done one of these RESPECT forms with his GP a while back, and he'd put hospital admission only for treatable conditions. Last week he got dehydrated (a treatable condition) and ended up semi-conscious so we called an ambulance and he was taken to hospital. He's very unhappy about still being there and saying he wished we hadn't called the ambulance.

If I were to respect his wishes and not call an ambulance to take him to hospital the next time this happens, how does this not make me an accomplice to suicide? Surely we're all responsible to do everything possible to keep someone alive, even if they don't want to be?

If he's of sound mind, then making someone undergo medical treatment against their will is abusive. It's not about assisting suicide, it's about letting them have control over their own body and life. This can be really hard for families, and counselling can help.

If he's not of sound mind, including if you have reason to believe he's depressed and wouldn't normally feel this way, then you need to talk to he / his doctors and look into getting him proper assessment and support.

Choosing to allow nature to take its course is not suicide. Suicide is a conscious act of self destruction.

If I was your DF, I would be seriously upset if you had my power of attorney. He’s an adult, he has made his choices as a sane and responsible person. You really should respect them ( and him).

Not against their wishes, no.
He has the right to determine if his quality of life warrants frequent hospital admissions.
He's completed the RESPECT form so you need to abide by its conditions.

If your father has capacity then he is entitled to make decisions however hard that is for you to accept. In the case last week it seems that the correct decision was made because you say the Respect card says hospital admittance for treatable conditions. But your father is entitled to be upset at being in hospital. I have family knowledge of end of life care. I know I would rather die at home than on a trolley in A&E. I would hope my relatives would be willing to respect my wishes.

He can sign himself out of hospital so he's being unfair blaming you for him still being there.
In future, keep copies of his forms. Call for medical treatment when he is ill. Then you can show the attending medical professionals the forms, and they can choose how to procreed.
Your DF has a right to choose his treatment. He doesn't have the right to choose your actions or blame you. He's being emotionally manipulative and bullying. You need to have firm boundaries about this - that protect you emotionally and legally.

Please respect your father's wishes, you will be old one day and the mental capacity act and advanced directives (DNACPR, RESPECT etc) will be the only things preventing you rights, wishes and years of life experience being walked all over by younger people who think they know better than you.

You did nothing wrong by doing what he’d set out in the RESPECT form, but if his wishes have changed he needs to update it.
Thats to protect you and help you feel confident in declining admission, but also for health care professionals. Even if we wants to die at home of something potentially reversible, it’s not as simple as not calling an ambulance. Depending on what happens the GP or district nurse or paramedics may be involved to prescribe antibiotics / manage pain / other symptoms at home and it needs to be crystal clear to them that he is not for admission.

Depends how old he is and any other underlying conditions. If he's not going to improve and has dementia, for example, it will spare you both a miserable existence. If he has made his wishes clear then you are not complicit in suicide.

If he was just dehydrated why is he still in hospital several days later? (I appreciate dehydration can be serious but it should resolve pretty quickly unless there is some underlying condition).

Respect is not legally binding. If he does not have capacity to make decisions (short term because unconscious or able to speak) then you have to act in his best interests taking his wishes into account.

He needs to get his respect form changed, or write an advance decision which is legally binding.

Organise power of attorney for health and welfare. I had this for my OH and refused to let him be taken into hospital for aggressive treatment for pneumonia (OH was unconscious) in the context of end stage Parkinsons. No-one batted an eyelid - they went with my/his wishes. I did not see myself as aiding a suicide, but simply honouring his wishes. And being humane - he was very paranoid and hallucinating - hospital would have been a terrifying experience for him.

I agree with @AlexandriasWindmill you do what you fee is right and pass the forms to the medical professional to proceed with as they see fit.
The bit about going in for treatable condition only is a big grey area and how are you supposed to know if he is unconscious with something treatable
or not. I think he deserve the right to choose but he is being unfair on you.

Well no, we aren't obligated to do anything to keep someone alive against their wishes, but it does sound like you felt that you were following his wishes at the time so there needs to be clarification re: what he means by "a treatable condition" for both your sakes.

It may well be that you don't feel you can abide by his wishes as it's against your conscience, and that is also your right, but in that case really you need hand the decision making in such circumstances over to someone else.

OP please ignore the posters telling you to ignore your own MH and legal liability. Your DF can leave hospital at any time. You are not keeping him there and you did not go against his wishes since his condition was treatable.

You need to go back to his GP and discuss the liability of an untrained medical professional (ie you!) trying to tiptoe round unclear and potentially illegal directives to try to appease your DF.

You followed directives exactly. He asked not to be ADMITTED for non-treatable conditions. You are not medically trained to assess this.

He was unwell, you did what you had to do which is call an ambulance. They took him to hospital, he was assessed and he was deemed to have a treatable condition at which point he was admitted. Had he gone to hosptial and it was deemed non-treatable he would not be admitted and discharged. He could discharge himself now if he wanted to, he has capacity. This is not on you and if he became that unwell again an ambulance is the right call.

How would LPOA help OP father as she is the one unwilling to follow his wishes? I think it is highly unlikely he would name her as LPoA, I guess their may be someone else in the family who would support his wishes though.

The law is also VERY specific about the order of when decisions where made, so even if he set up a LPOA he could still subsequently write an advanced directive (assuming he had capacity at the time) after setting up LPOA and the advanced directive would stand over the decisions it covers.

Once he is unconscious, the choice of calling an ambulance or not is no longer his. He can decide DNR, he can't decide that you are not to call an ambulance for him if he is unconscious - just tell him, you will be calling an ambulance in that situation, and if he doesn't want to accept treatment once he is in hospital, that is up to him.

If he drops unconscious in the street and none of the family are with him, I assume an ambulance will be called In which case he will have to self-discharge?
Is he presuming that you’ll care for him 24/7 at home while he’s unconscious? That’s a massive ask.
I’m really not sure how you stand in those circumstances by not getting medical help - would you defy any doctor who says he needs admission?

OP is perfectly entitled to call an ambulance but should not knowingly withhold the RESPECT form from the ambulance crew who should then act on it accordingly.

It is not clear what has happened here. Whether the ambulance crew were shown the form, if they were if they acted outside of guidelines, or if the form was not properly completed.

His condition was treatable. No-one acted outwith his wishes. He is bullying OP for no reason and posters shouldn't be enabling it.

The thread title differs greatly from the first post. So impossible to know what his wishes as stated on the form were.

We had this situation with my dad. We did the respect form with his GP present. He was very terminally ill though, so the GP came to the house and updated his records accordingly. Dad died at home a week after.

@Stormydayagain OP's post is clear about what happened. RESPECT forms are about clinical judgement and patient preference. There is no form that can legally compel OP not to call an ambulance.

There is no confusion. The RESPECT form does not enable paramedics to leave a person unconscious at home without ascertaining their condition, treatment and possible care. Their clinical judgement was to admit him. Her DF is now alert and able to discuss his preferences with the ward professionals.

No, I don't think "we're responsible to do everything possible to keep someone alive, even if they don't want to be?"

I worked for many years as a care worker, and most of the elderly people I went to said they wouldn't want to go to hospital if they became unwell. Two years ago, something major happened to me, and I was put in an induced coma (so had no choice but to go to hospital, where I was an inpatient for 6 weeks). Having been in hospital and been subjected to some pretty awful "care", I've told my family that under no circumstances do I ever want to be taken to hospital or be kept alive. I've got a DNR on file, although I'm "only" in my 60s

Op you did what you were meant to. He was semi conscious with a treatable condition. As per his wishes, that isn't something he said he didn't want to go on with.

I don't know what the implications are for leaving him at home to die naturally in those circumstances without his wishes being explicitly recorded?

Having seen an elderly loved one removed to hospital, aggressively treated, and then spend two years in a home not recognising anyone including her husband and children, totally dependent and very confused as the general anaesthetic from the life saving surgery caused her such damage?

We all knew afterwards she and her husband would have very very much preferred that she was made comfortable and allowed to go, in her own bed, able to say goodbye to him while knowing who he was. He said to me in tears at her funeral he'd said goodbye to her two years earlier.

It is very difficult, but elderly people should have the right not to be pressured into treatment and prolonging of life that they don't want, because relatives with more power don't agree with them. Her husband later had an excellent GP and agreed with him that the GP would personally visit him and make a decision with him on what treatment and on what terms if hospital admission looked necessary.